拉斯米坦、利美盖潘和乌布盖潘用于三苯氧胺反应不足者偏头痛急性期治疗的疗效:系统综述和网络荟萃分析。

IF 7.3 1区 医学 Q1 CLINICAL NEUROLOGY Journal of Headache and Pain Pub Date : 2024-11-08 DOI:10.1186/s10194-024-01904-1
Wattakorn Laohapiboolrattana, Priabprat Jansem, Prakit Anukoolwittaya, Duangnapa Roongpiboonsopit, Akarin Hiransuthikul, Thanakit Pongpitakmetha, Sekh Thanprasertsuk, Wanakorn Rattanawong
{"title":"拉斯米坦、利美盖潘和乌布盖潘用于三苯氧胺反应不足者偏头痛急性期治疗的疗效:系统综述和网络荟萃分析。","authors":"Wattakorn Laohapiboolrattana, Priabprat Jansem, Prakit Anukoolwittaya, Duangnapa Roongpiboonsopit, Akarin Hiransuthikul, Thanakit Pongpitakmetha, Sekh Thanprasertsuk, Wanakorn Rattanawong","doi":"10.1186/s10194-024-01904-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Novel abortive treatments for migraine, ditans and gepants, have promising implications in triptan-insufficient responders with minimal existing comparative data. Our study aims to synthesize evidence through a systematic review and network meta-analysis to assess the comparative efficacy of lasmiditan, rimegepant and ubrogepant in triptan-insufficient responders.</p><p><strong>Method: </strong>We searched PubMed, Embase, CENTRAL, and EBSCO Open Dissertations up to May 2024. We included randomized controlled trials (RCTs) that compared novel abortive treatments, including lasmiditan, rimegepant, and ubrogepant, in migraine patients who self-reported insufficient response to triptans. Outcomes are represented using relative risks with corresponding 95% confidence intervals (CI). The surface under the cumulative ranking curve (SUCRA) was used to rank each medication.</p><p><strong>Results: </strong>A total of five phase 3 RCTs involving 3,004 patients were included in the analysis. All three agents were significantly superior to placebo for two-hour pain freedom (RR = 1.93, 95% CI [1.52, 2.46]), freedom from the most bothersome symptoms at two hours (RR = 1.55, 95% CI [1.37, 1.75]), and pain relief at two hours (RR = 1.46, 95% CI [1.35, 1.58]). No statistically significant differences in efficacy outcomes were observed among the three agents. However, lasmiditan 200 mg had the highest cumulative probability for two-hour pain freedom and relief (SUCRA 0.9, 0.8, respective), while rimegepant led in relieving the most bothersome symptoms (SUCRA 0.7).</p><p><strong>Conclusion: </strong>Lasmiditan, rimegepant, and ubrogepant are effective for acute treatment of migraine in triptan-insufficient responders, with high-dose lasmiditan showing the highest efficacy for pain control.</p>","PeriodicalId":16013,"journal":{"name":"Journal of Headache and Pain","volume":"25 1","pages":"194"},"PeriodicalIF":7.3000,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544997/pdf/","citationCount":"0","resultStr":"{\"title\":\"Efficacy of lasmiditan, rimegepant and ubrogepant for acute treatment of migraine in triptan insufficient responders: systematic review and network meta-analysis.\",\"authors\":\"Wattakorn Laohapiboolrattana, Priabprat Jansem, Prakit Anukoolwittaya, Duangnapa Roongpiboonsopit, Akarin Hiransuthikul, Thanakit Pongpitakmetha, Sekh Thanprasertsuk, Wanakorn Rattanawong\",\"doi\":\"10.1186/s10194-024-01904-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Novel abortive treatments for migraine, ditans and gepants, have promising implications in triptan-insufficient responders with minimal existing comparative data. Our study aims to synthesize evidence through a systematic review and network meta-analysis to assess the comparative efficacy of lasmiditan, rimegepant and ubrogepant in triptan-insufficient responders.</p><p><strong>Method: </strong>We searched PubMed, Embase, CENTRAL, and EBSCO Open Dissertations up to May 2024. We included randomized controlled trials (RCTs) that compared novel abortive treatments, including lasmiditan, rimegepant, and ubrogepant, in migraine patients who self-reported insufficient response to triptans. Outcomes are represented using relative risks with corresponding 95% confidence intervals (CI). The surface under the cumulative ranking curve (SUCRA) was used to rank each medication.</p><p><strong>Results: </strong>A total of five phase 3 RCTs involving 3,004 patients were included in the analysis. All three agents were significantly superior to placebo for two-hour pain freedom (RR = 1.93, 95% CI [1.52, 2.46]), freedom from the most bothersome symptoms at two hours (RR = 1.55, 95% CI [1.37, 1.75]), and pain relief at two hours (RR = 1.46, 95% CI [1.35, 1.58]). No statistically significant differences in efficacy outcomes were observed among the three agents. However, lasmiditan 200 mg had the highest cumulative probability for two-hour pain freedom and relief (SUCRA 0.9, 0.8, respective), while rimegepant led in relieving the most bothersome symptoms (SUCRA 0.7).</p><p><strong>Conclusion: </strong>Lasmiditan, rimegepant, and ubrogepant are effective for acute treatment of migraine in triptan-insufficient responders, with high-dose lasmiditan showing the highest efficacy for pain control.</p>\",\"PeriodicalId\":16013,\"journal\":{\"name\":\"Journal of Headache and Pain\",\"volume\":\"25 1\",\"pages\":\"194\"},\"PeriodicalIF\":7.3000,\"publicationDate\":\"2024-11-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11544997/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Headache and Pain\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s10194-024-01904-1\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Headache and Pain","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s10194-024-01904-1","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:治疗偏头痛的新型中止治疗药物(ditans和gepants)对三苯氧胺反应不足的患者有很好的疗效,但现有的比较数据极少。我们的研究旨在通过系统综述和网络荟萃分析综合证据,评估拉斯米坦、利美盖潘和乌布盖潘对三苯氧胺反应不足者的疗效比较:我们检索了截至 2024 年 5 月的 PubMed、Embase、CENTRAL 和 EBSCO Open Dissertations。我们纳入了对自我报告对曲普坦反应不足的偏头痛患者的新型中止治疗进行比较的随机对照试验(RCT),包括拉斯米坦、利美昔潘和乌布曲普坦。结果用相对风险和相应的 95% 置信区间 (CI) 表示。累积排名曲线下表面值(SUCRA)用于对每种药物进行排名:分析共纳入了 5 项 3 期 RCT,涉及 3004 名患者。在两小时无疼痛(RR = 1.93,95% CI [1.52,2.46])、两小时无最令人烦恼的症状(RR = 1.55,95% CI [1.37,1.75])和两小时疼痛缓解(RR = 1.46,95% CI [1.35,1.58])方面,三种药物均明显优于安慰剂。三种药物的疗效结果在统计学上没有明显差异。不过,拉斯米坦 200 毫克两小时无痛和缓解疼痛的累积概率最高(SUCRA 分别为 0.9 和 0.8),而利美昔班在缓解最令人烦恼的症状方面领先(SUCRA 为 0.7):结论:拉斯米坦、利美呱和乌洛格潘对三苯氧胺反应不足者的偏头痛急性期治疗有效,其中大剂量拉斯米坦对疼痛控制的疗效最高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Efficacy of lasmiditan, rimegepant and ubrogepant for acute treatment of migraine in triptan insufficient responders: systematic review and network meta-analysis.

Background: Novel abortive treatments for migraine, ditans and gepants, have promising implications in triptan-insufficient responders with minimal existing comparative data. Our study aims to synthesize evidence through a systematic review and network meta-analysis to assess the comparative efficacy of lasmiditan, rimegepant and ubrogepant in triptan-insufficient responders.

Method: We searched PubMed, Embase, CENTRAL, and EBSCO Open Dissertations up to May 2024. We included randomized controlled trials (RCTs) that compared novel abortive treatments, including lasmiditan, rimegepant, and ubrogepant, in migraine patients who self-reported insufficient response to triptans. Outcomes are represented using relative risks with corresponding 95% confidence intervals (CI). The surface under the cumulative ranking curve (SUCRA) was used to rank each medication.

Results: A total of five phase 3 RCTs involving 3,004 patients were included in the analysis. All three agents were significantly superior to placebo for two-hour pain freedom (RR = 1.93, 95% CI [1.52, 2.46]), freedom from the most bothersome symptoms at two hours (RR = 1.55, 95% CI [1.37, 1.75]), and pain relief at two hours (RR = 1.46, 95% CI [1.35, 1.58]). No statistically significant differences in efficacy outcomes were observed among the three agents. However, lasmiditan 200 mg had the highest cumulative probability for two-hour pain freedom and relief (SUCRA 0.9, 0.8, respective), while rimegepant led in relieving the most bothersome symptoms (SUCRA 0.7).

Conclusion: Lasmiditan, rimegepant, and ubrogepant are effective for acute treatment of migraine in triptan-insufficient responders, with high-dose lasmiditan showing the highest efficacy for pain control.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Journal of Headache and Pain
Journal of Headache and Pain 医学-临床神经学
CiteScore
11.80
自引率
13.50%
发文量
143
审稿时长
6-12 weeks
期刊介绍: The Journal of Headache and Pain, a peer-reviewed open-access journal published under the BMC brand, a part of Springer Nature, is dedicated to researchers engaged in all facets of headache and related pain syndromes. It encompasses epidemiology, public health, basic science, translational medicine, clinical trials, and real-world data. With a multidisciplinary approach, The Journal of Headache and Pain addresses headache medicine and related pain syndromes across all medical disciplines. It particularly encourages submissions in clinical, translational, and basic science fields, focusing on pain management, genetics, neurology, and internal medicine. The journal publishes research articles, reviews, letters to the Editor, as well as consensus articles and guidelines, aimed at promoting best practices in managing patients with headaches and related pain.
期刊最新文献
The PopHEAD study: a population-based, cross-sectional study on headache burden in Norway: methods and validation of questionnaire-based diagnoses. Formoterol dynamically alters endocannabinoid tone in the periaqueductal gray inducing headache. Serum microRNA qPCR profiling and validation indicate upregulation of circulating miR-145-5p and miR-26a-5p in migraineurs. The prevalence of headache disorders among medical students in Vietnam: a cross-sectional study. Attentional network deficits in patients with migraine: behavioral and electrophysiological evidence.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1